Abstract: The significance of early screening, diagnosis, and treatment for lung cancer, a disease with high incidence and mortality rates, is increasingly acknowledged. In comparison to traditional invasive examination methods, breath analysis technology utilizing gas sensors presents notable advantages, including low cost, non-invasiveness, and rapid diagnosis, thereby offering a highly promising approach for early lung cancer detection. Metal oxide semiconductor gas sensors, which are easily integrated and simple to operate, have attracted considerable attention. This paper reviews recent advancements in semiconductor gas sensors for the detection of early lung cancer. Initially, we introduce low-dose computed tomography methods, exhaled biomarkers associated with lung cancer, and the operating principle of gas sensors. Subsequently, we summarize the sensing performance and enhancement mechanisms of novel metal oxide semiconductor gas sensors for lung cancer biomarker gases. The current status and challenges of electronic nose technology and intelligent algorithms in early lung cancer screening are discussed. Finally, future perspectives on semiconductor gas sensor-based early lung cancer screening technologies are presented.